Diagnosing acute-phase infection with varicella-zoster virus
Immunofluorescence Assay (IFA)
Chicken Pox
Herpes Zoster antibodies
Varicella-Zoster Virus (VZV)
VZV (Varicella-Zoster Virus)
Serum
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
0.2 mL
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Heat-inactivated specimen | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Frozen | 14 days |
Diagnosing acute-phase infection with varicella-zoster virus
Varicella-zoster virus (VZV), a herpes virus, causes 2 distinct exanthematous (rash-associated) diseases: chickenpox (varicella) and herpes zoster (shingles). Chickenpox is a highly contagious, though typically benign, disease, usually contracted during childhood. Chickenpox is characterized by a dermal vesiculopustular rash that develops in successive crops approximately 10 to 21 days following exposure.(1) Although primary infection with VZV results in immunity and protection from subsequent infection, VZV remains latent within sensory dorsal root ganglia and upon reactivation, manifests as herpes zoster or shingles. During reactivation, the virus migrates along neural pathways to the skin, producing a unilateral rash, usually limited to a single dermatome. Shingles is an extremely painful condition typically occurring in older nonimmune adults or those with waning immunity to VZV and in patients with impaired cellular immunity.(2)
Several populations are at risk of suffering unusually severe reactions to VZV infections. The infection in women who are pregnant may spread through the placenta to the fetus causing congenital disease in the infant. Immunocompromised patients in hospitals may contract severe nosocomial infections from others who have active VZV infections and are at risk for developing severe VZV-related complications, which include cutaneous disseminated disease and visceral organ involvement.(2,3) Therefore, serologic screening of direct healthcare providers (physicians, allied healthcare personnel) and individuals in high-risk groups is necessary to avoid uncontrolled spread of infection.
While the clinical presentation of VZV infection is generally characteristic, serologic evaluation of patients with atypical and systemic infections is often required. For example, it is extremely important to serologically evaluate patients for the early detection of VZV infections in hospital settings. Nosocomial spread of VZV infection can be life-threatening to immunocompromised patients susceptible to infection.
Negative
Reference values apply to all ages.
A positive IgM result indicates a recent infection with varicella-zoster virus (VZV).
A negative result does not rule out the diagnosis of VZV infection.
The performance characteristics with individuals vaccinated with
The test must be performed on serum. The use of whole blood,
Positive results from cord blood or neonates should be interpreted
Results from immunocompromised patients should be interpreted
1. Yankowitz J, Grose C. Congenital infections. In: Storch GA, ed. Essentials of diagnostic virology. Churchill Livingstone; 2000:187-201
2. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347(5):340-346
3. Cvjetkovic D, Jovanovic J, Hrnjakovic-Cvjetkovic I, Brkic S, Bogdanovic M. Reaktivacija herpes zoster infekcije varicela-zoster virusom [Reactivation of herpes zoster infection by varicella-zoster virus]. Med Pregl. 1999;52(3-5):125-128
4. Flamholc L. Neurological complications in herpes zoster. Scand J Infect Dis. 1996;100:35-40
5. Whitely RJ. Chickenpox and Herpes Zoster (Varicella-Zoster virus). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:1849-1856
The presence or absence of IgM class antibody to VZV is determined by an immunofluorescence assay (IFA).(Landry ML, Cohen SD, Mayo DR, et al: Comparison of fluorescent-antibody to membrane-antigen test, indirect immunofluorescence assay, and a commercial enzyme-linked immunosorbent assay for determination of antibody to varicella-zoster virus. J Clin Microbiol 1987;25:832-835)
Monday through Saturday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
86787
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
VZM | Varicella-Zoster Ab, IgM, S | 43588-3 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
80964 | Varicella-Zoster Ab, IgM, S | 43588-3 |